Associations Between Initial Presentation of Multiple Myeloma and Renal Function: the Experience of Two European Centers

Francesco Rainone, Sayyid M. Ammar Raza, James Ritchie, Lino Merlino, Helen Alderson, Diana Chiu, Mark Guy, Magda Marcatti, Philip Kalra

Abstract


Background: This study aimed to describe the baseline renal, histopathological and hematological characteristics and any clinical or biochemical associations of patients with a first coded diagnosis of multiple myeloma (MM). The incidence of renal replacement therapy (RRT) and association with mortality were also investigated.

Methods: A retrospective case review was performed to identify 287 MM patients from two European centers. Statistical analyses were performed using SPSS version 2.0 and SAS version 9.2.

Results: MM patients referred to renal centers were more likely to be elderly and male. The most common form of renal impairment was acute kidney injury (AKI). The most common paraprotein-associated lesions were myeloma cast nephropathy (MCN, 51%), light chain deposition disease (17%) and AL-amyloidosis (9.4%). MM with AKI was found to be a more aggressive disease, being associated with worse hematological features and increased risk of short-term death. Of the AKI patients requiring RRT, 80% required it at presentation. There was no increased risk of death in the RRT requiring vs. non-RRT requiring cohort. Monoclonal gammopathy of undetermined significance (MGUS) may predispose to renal damage and may increase likelihood of AKI in context of MM.

Conclusion: MM-related renal failure is a medical emergency with the need for rapid diagnosis and prompt supportive care, RRT and MM-directed therapy.




J Hematol. 2016;5(1):8-16
doi: http://dx.doi.org/10.14740/jh229w

 


Keywords


Multiple myeloma; Acute kidney injury; Myeloma complications; Myeloma pathology

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